Modern Medicine? (Part 3)

This is the third of two articles (yes, I’m aware of the math problem) looking into the difference between “modern” medicine and “wellness” medicine. This article was written in response to requests from local healthcare professionals that felt additional information would be beneficial…

The Checklist Manifesto, written by surgeon Atul Gawande, recounts a study that found the average patient in the ICU required 178 individual actions PER DAY. That’s one hundred seventy eight chances per day to miss a step and cause patient harm. More patients die from preventable medical errors each year than from motor vehicle accidents, breast cancer, or AIDS according to the 1999 report published by the Institute of Medicine. We are all prone to making mistakes. Doctors can’t do it alone.

Nurses are the backbone of both modern medicine and wellness medicine. They are another layer of patient safety and information. Their close contact with patients places them in the position to help catch medical errors and educate patients. I recently spoke to a nurse who exhibited her displeasure that she wasn’t allowed to appropriately counsel a patient upon discharge for fear of affecting the patient satisfaction survey numbers. Nurses are rewarded for being “nice”, not for educating patients, not for providing good, safe patient care. Hospitals shouldn’t be a place to go to be treated nicely, they should be a place to go for good care. The goal of being hospitalized is to get the patient well enough to be discharged and not have the need to come back.

If a patient satisfaction survey is to be used, in my opinion it should be short. A one-question survey with a yes or no response should suffice. “While you were hospitalized, did the doctors, nurses, and techs do their best to ensure that your overall health improved since the time of admission?” Yes? No action needed. A no answer would necessitate an automatic visit with the hospital administrator to discuss either a failure with the provision of healthcare or a failure in communication. Survey companies are not in the business of improving patient care. They are in the business of taking needed money away from healthcare provision. Ask your hospital administrator how much the survey companies receive in compensation. I bet you won’t get a straight answer.

Why are patient satisfaction survey scores used as a metric for healthcare provision? It is much easier to measure patient satisfaction than it is to measure good, safe care. When doctors and nurses provide good patient care, patients will get better, get worse, or stay the same. Unfortunately, when doctors and nurses provide poor patient care, patients will get better, get worse, or stay the same.

Where does patient satisfaction come in? It certainly weighs heavily on the “getting worse” side according to the March 2012 Archives of Internal Medicine study quoted in last week’s article. I don’t advocate being rude to patients but I do think my role should not be that of a friend or buddy but rather someone using my years of training to help you get better by appropriately utilizing the available technology.

We need to take a stand against the medical machine that is “modern” medicine. Mail the surveys back, but don’t fill them out. Call your hospital administrator and let him know that you not only appreciated surviving your hospitalization but you valued the patient education and safety that was provided. Didn’t receive any patient education prior to discharge? Let him know. We need to show dissatisfaction with a healthcare system that encourages doctors and nurses to willfully ignore their duty to address risk factors that contribute to our decline in “wellness”.

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. The opinions given here reflect a new way of thinking about medicine and are not necessarily endorsed by the U.S. Air Force, Lincoln County Medical Center, or even his wife. Comments or questions? His email address is: